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Family Initiative is a nonprofit impact organization based in Southwest Florida to support children, teens, and young adults with autism and their families. Family Initiative is constantly working to better support the autism community, and is seeking input from families about their response and needs during emergencies such as hurricanes. If you feel like you can assist with this, please complete the survey. To learn more about Family Initiative, visit fi-florida.org.

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* 1. Choose all of the following that heavily influence your decision to evacuate for a hurricane.

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* 2. Check the categories of storms/hurricane for which you plan to evacuate in the future

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* 3. If you DO NOT plan to evacuate, choose all reasons that contribute to why you will shelter in place at home.

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* 4. What are your current evacuation plans for a major hurricane?

  Friend's Home Relative's Home Hotel/Home Rental/Other paid option Emergency Evacuation Shelter
Within Lee County
Within SW Florida
Within Florida
Out of State

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* 5. How do you receive/look for the most reliable news on tropical weather/hurricanes and possible evacuation orders?  Choose all that apply.

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* 7. Check all areas in which your family is currently prepared.

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* 8. After a hurricane, what are the most urgent PERSONAL needs your family will have that you CANNOT MEET. Check all that apply.

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* 9. After a hurricane, what are the most urgent RECOVERY needs that you CANNOT meet.

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* 10. What are the most critical services your child is currently receiving from Family Initiative or other provider that you will need within one week after a hurricane.

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* 11. What skills or abilities can you volunteer after a hurricane to assist the Family Initiative/autistic community?

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* 12. Do you follow Lee County Public Safety on social media? Check all that apply. 

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* 13. Do you follow Lee County Government on social media? Check all that apply.

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* 14. How many people are in your immediate family? (# of people reflected in your answers)

1 8 15
Clear
i We adjusted the number you entered based on the slider’s scale.

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* 15. How many pets do you have?

  0 1 2 3 4 +
Dogs
Cats
Other

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* 16. What county do you live in?

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* 17. What is your name?

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* 18. What is your email address? 

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* 19. What is the address where you currently live?

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* 20. May we contact you again in the future? Choose preferred methods of contact.

 
100% of survey complete.

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